Aqueous humour and plasma cortisol levels in glaucoma and cataract patients

Abstract

By means of radioimmunoassay, the content of endogenous cortisol in the aqueous humour and plasma of 35 patients suffering from various types of glaucomas and 35 cataract patients was determined, and the ratio of the plasma to the aqueous humour cortisol levels was calculated. The highest cortisol level in both plasma and aqueous humour was found to occur in patients with open-angle glaucoma suffering at the same time from systemic hypertension. The lowest plasma to aqueous humour cortisol ratio was found in patients with secondary glaucoma treated with steroids. In woman suffering from open-angle glaucoma, the rising cortisol level in plasma with age contrasted to the decreasing cortisol level in aqueous humour. The authors suggest that there is an active interference with homeostatic mechanisms responsible for ensuring the stability of the eye inner milieu and a certain protection of the trabecular meshwork of the angle of the anterior eye chamber against noxious effects of the endogenous cortisol.

Dexamethasone alters F‐actin architecture and promotes cross‐linked actin network formation in human trabecular meshwork tissue

“…Although still controversial, plasma and aqueous humor cortisol levels have been reported to be elevated in POAG patients [Rozsival et al, 1981;Schwartz et al, 1987;Stokes et al, 2003]. Further, although approximately 30-40% of the normal population, often referred to as \steroid responders," develop elevated IOP when treated with topical ocular glucocorticoids, the steroid responder rate is much higher in POAG patients [Clark and Morrison, 2002].…”

Decreased Response of Plasma Cortisol to Intravenous Metyrapone in Ocular Hypertension and Primary Open-Angle Glaucoma

“…Increased plasma cortisol, both total and free, as well as non-plasma glucocorticoids have been identified in OH and OAG compared with normals. [1][2][3][4][5][6] This present study was done on subjects hospitalized in a clinical study unit. This was in contrast to our previous studies on plasma cortisol levels, which were done on outpatients.…”

“…Plasma cortisol levels have been shown to be increased in ocular hypertensives and open-angle glaucomas. [1][2][3][4][5][6] The increased level of plasma cortisol could be on the basis of an abnormality in the control mechanism for maintaining levels of plasma cortisol. A decrease in level of plasma cortisol stimulates the hypothalamic-pituitary complex to produce more ACTH, which, in turn, stimulates the adrenal cortex to increase the level of plasma cortisol.…”

Endogenous Cortisol and TGF-β in Human Aqueous Humor Contribute to Ocular Immune Privilege by Regulating Dendritic Cell Function

“…4C). Other studies detecting cortisol by RIA have reported values ranging from 4.8 to 49.7 nM (equivalent to 1.7-18.0 ng/ml) (20,21,29,30). Interestingly, the binding protein cortisol-binding globulin was not present at detectable levels (by RIA) (20).…”